Scientific research aims to answer relevant clinical questions that are of benefit for the health of a patient or a group of patients. In practice, scientific research is performed by a team of senior researchers (e.g. professors), junior researchers (e.g. PhD students, post-docs), study nurses and clinicians who work closely together. Research activities are usually confined to a single institution, local or national consortia within countries. Large international initiatives are upcoming and increasing in numbers. We have to question the ethics of involving patients in underpowered trials particularly when heterogeneity in study design reduces reasonable integration of results with meta-analysis to look for common effects. International collaboration is necessary to provide sufficient power to answer research questions with clinically relevant outcome measures, particularly for a disease with complex pathophysiology such as spontaneous preterm birth. In a time marked by financial crisis and budget restrictions, we have the responsibility to lead more efficient and effective research projects. 

Currently, international networks mainly constitute of senior researchers and participation by junior researchers is unusual. However, in the next decades the current generation of junior researchers will evolve to be the next generation of senior researchers, therefore early involvement of junior researchers will be beneficial to the overall research effort.