en Obstetrics and Gynecology Care Obstetrics and Gynecology Care پژوهشی اصيل Original Research <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Aims: </span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Recurrent pregnancy loss (RPL) imposes a profound psychological burden. This study aimed to compare general health, marital satisfaction, and subjective happiness between women with RPL and healthy controls, and to elucidate the mediating pathways linking RPL to relational outcomes.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Methods: </span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">In this matched case-control study conducted in 2025 in Shushtar, Iran, 210 reproductive-aged women (71 with RPL, 140 healthy controls matched by age, socioeconomic status, and gravidity) were recruited. Participants completed the General Health Questionnaire (GHQ-28), ENRICH Marital Satisfaction Inventory, and Oxford Happiness Questionnaire. Data were analyzed using Mann-Whitney U tests, stepwise multiple regression, and path analysis to evaluate direct and indirect effects.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Findings: </span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Women with RPL exhibited significantly poorer general health (40.89&plusmn;17.07 vs. 23.41&plusmn;15.44, p<0.001), lower happiness (29.65&plusmn;19.11 vs. 43.86&plusmn;16.04, p<0.001), and reduced marital satisfaction (123.58&plusmn;59.91 vs. 163.01&plusmn;54.56, p=0.001) compared to controls. Crucially, path analysis revealed that RPL status did not directly diminish marital satisfaction. Instead, its detrimental effect was fully mediated by compromised general health and reduced happiness (indirect effect &beta;=0.297, p<0.001).</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:107%"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion: </span></span></span></b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Women with RPL experience poorer general health, lower happiness, and reduced marital satisfaction than healthy controls. &nbsp;Path analysis suggests that RPL may indirectly affect marital satisfaction through compromised health and happiness. These findings support integrating psychosocial care into RPL management. However, longitudinal studies are needed to confirm causal pathways.</span></span></span></span></span></span><br> &nbsp; ,Recurrent pregnancy loss,Marital satisfaction,Psychological well-being,Happiness,Case-control study,Women's health 1001 1010 http://jccs.yums.ac.ir/browse.php?a_code=A-10-317-2&slc_lang=en&sid=1 R. Rezaei Rana.rezaei9288@gmail.com 10031947532846006622 10031947532846006622 No S. Mohammadi Sl.Mohammadi89@yahoo.com 10031947532846006623 10031947532846006623 No A. Jahangirimehr a.jahangirimehr@gmail.com 10031947532846006624 10031947532846006624 No Z.S. Pajohideh pajohidehz@gmail.com 10031947532846006625 10031947532846006625 Yes