Title: Neonatal outcome and risk factors for delivery of hypertrofic newborn Introduction: Certain risk factors are associated with the occurrence of neonatal hypertrophy, and the birth of such child is challenge for mother and child because birth injuries are common. Design: Historical cohort study Objective is to examine the epidemiological characteristics of mothers and children born in the period from 2017 to 2019 and to examine the incidence and possible changes that occurred during that period. Risk factors in the mother, as well as complications in childbirth, were also investigated. Both the clinical characteristics and neonatal outcome of hypertrophic newborn children was observed and periods were compared to determine if a change had occurred. Methods and subjects : The subjects were hypertrophic newborns with a birth weight of 4000 grams or more, who were born in Clinical Hospital Centre Osijek in the period from 2017 to 2019. The data were presented in tables, in absolute and relative frequencies. Chi-square test was used to demonstrate the statistical significance, resulting in significance level of p < 0.05. Results : A significant increase was noted in the frequency of births of hypertrophic newborns from the first pregnancy, and an increase in the number of births by the cesarean section, as well as a significant increase in the proportion of children with complications during childbirth. The need for ventilation increases slightly, but the percentage of children who are ventilated invasively decreases, and non-invasively increases.The need for oxygenation is constant. The length of hospitalization is shortened. Conclusion : The development of perinatal care has the effect of reducing complications in hypertrophic newborns - the length of hospitalization is reduced, and non-invasive methods of mechanical ventilation are used during treatment. The number of births of hypertrophic newborns by caesarean section is increased to avoid birth injuries and trauma for both the mother and the child.