For those who’ve suffered the loss of a baby in the first year of life, that death may mean an increased risk of stillbirth with the next pregnancy, a new study has found.

Researchers found an average rate of stillbirth during a second pregnancy at about four per 1,000 births. But the risk was three times as high for women who lost their first baby in its first year. The study was based on medical records of over 300,000 women in Missouri between 1989 and 2005. The findings were published in the obstetrics journal BJOG.

The exact cause of a stillbirth is unknown in 50 to 60 percent of cases, said Dr. Hamisu Salihu, a professor at the University of South Florida who worked on the study.

It’s possible that whatever underlying conditions may have contributed to the first child’s death – whether genetic or environmental (e.g., stunted growth due to exposure to cigarette smoke) -- may have also contributed to the fetal death in the second pregnancy, according to Salihu.

"Couples should not give up," Salihu said. He recommends "preconception" counseling to help identify any existing risk factors. "Some of those risk factors are modifiable."