Introduction. The birth of a hypotrophic newborn carries complications in clinical status and adjustment to ectopic living conditions. There are risk factors on the part of the mother and fetus that contribute to the birth of a hypotrophic newborn. Study design. Retrospective cohort study. Objectives. The aim is to examine possible changes that have occured in the incidence of the birth of hypotrophic newborns, the epidemiological characteristics of mothers and newborns, maternal risk factors, complications during childbirth and symptoms in the clinical picture and neonatal outcome in the three-year period. Participants and methods. The research was conducted on hypotrophic live-born infants over a three-year period of birth weight up to 2,900 grams in the Clinical Hospital Centre Osijek between 2017 and 2019. The data were presented in tables, expressed by frequency and share for nominal variables. Chi-square test and Fisher's exact test were used to demonstrate the statistical significance, resulting in a significance level of P < 0.05. Results. In the three-year observation period, changes in the incidence of cesarean section and changes in the vitality of the newborn were observed. Also, a change in labor complication associated with oligohydramnios and polyhydramnios was observed. Respiratory suffering, as a symptom of a hypotrophic newborn, is on the rise in the three-year observation period. There were changes in the diet, an increase in the number of newborns who were exclusively breastfed in a three-year period. Reduced number of days of hospitalization for newborns born by vaginal birth. Conclusion. With the screening and development of perinatological care, the number of pregnancies ending in cesarean section has been reduced. It is also a better outcome of neonatal vitality and clinical picture in perinatal period. With the development of neonatological care, the length of hospitalization of the newborns has been reduced.