A prospective longitudinal interventional cohort study on maternal nutrition and pregnancy outcomes in urban Cameroon (CAMELIA): study protocol

BACKGROUND: Maternal nutritional exposures during pregnancy are critical determinants of maternal and neonatal outcomes, yet remain inadequately characterized in many African settings, including Cameroon. The CAMELIA (Cameroon Maternal and Early Life Assessment) cohort aims to evaluate maternal nutritional status early in pregnancy, implement a structured nutritional intervention, and assess its impact on maternal, neonatal, and long-term metabolic outcomes. METHODS: CAMELIA is a prospective, longitudinal interventional cohort enrolling 1,200 pregnant women at less than 22 weeks' gestation in an urban primary healthcare facility in Cameroon (Hôpital Monseigneur Jean Zoa, Yaoundé). Participants are recruited at the first antenatal visit and followed through delivery and up to 42 days postpartum. Data and biological samples are collected across four visits: at enrolment (< 22 weeks), between 24 and 32 weeks of gestation, at delivery, and at 42 days postpartum. A structured multi-modal nutritional intervention (SUN-APP program) is initiated at enrolment, delivered through individual counselling, group education, monthly interactive workshops, and digital health support via weekly WhatsApp and SMS messages. Gestational hyperglycaemia is screened using fasting capillary blood glucose at V1 and V2, applying a threshold of ≥ 92 mg/dL. Primary outcomes are feasibility and acceptability of the intervention. Secondary outcomes include prevalence of gestational hyperglycaemia, hypertensive disorders, anaemia, low birth weight, and preterm birth. The study holds ethical approval from the Cameroon National Ethics Committee (CNERSH; approval no. 2025/04/1790/CE/CNERSH/SP) and is registered in the ISRCTN registry (ISRCTN13961105). CONCLUSIONS: The CAMELIA study provides a scalable and replicable framework for embedding structured nutritional risk screening and targeted interventions into routine antenatal care in a low-resource African setting. Findings will inform strategies for the prevention of gestational metabolic disorders and adverse perinatal outcomes across generations. TRIAL REGISTRATION: ISRCTN13961105. Registered 14 August 2025.