Sad News for the Happy Hour

A city's bars caution mothers-to-be about drinking

Manhattan's Le Zinc restaurant, with its high ceiling and zinc-topped bar, is a popular spot for New Yorkers to relax with dinner and a drink after work. But last week the atmosphere be came less convivial for those pregnant women accustomed to their evening cocktail. On a mirrored wall behind the bar, amid an array of posted regulations, a new sign in stark black lettering went up. It read: "Warning: Drinking Alcoholic Beverages During Pregnancy Can Cause Birth Defects."

The sign was posted in accordance with a newly passed New York City health regulation requiring such notices in all bars, restaurants and liquor stores in the city. The regulation is the nation's first, but already the state legislatures in New York and Maine are considering similar laws. A proposal to put warning labels on alcoholic beverages has been introduced in Congress a number of times over the past five years, but without success. The most influential statement on the subject to date: a 1981 warning by the U.S. Surgeon General that pregnant women should avoid alcohol entirely.

Many U.S. doctors believe that the evidence against alcohol is strong enough to warrant strict warnings. But others disagree and doubt that warning signs are justified. Basically, physicians are disputing the degree of alcohol consumption necessary to risk the abnormalities that physicians call FAS, for fetal alcohol syndrome. Says Dr. Robert J. Sokol, an obstetrician at Wayne State University: "It's questionable whether there has ever been a case of an FAS child born to less than a chronically addicted woman." Dr. John Larsen of George Washington University even takes issue with the Surgeon General's findings. There is no evidence, he says, that "one glass of wine has any damaging effect." His concern is that the posting of signs will serve only "to burden with guilt the well educated and sensitive, without having any effect on pregnant women who are heavy drinkers." Indeed, says Boston University Psychiatrist Henry Rosett, such warnings might create anxiety that could threaten the health of a pregnant woman and her child.

Although the dangers of alcohol consumption during pregnancy were recognized by the ancient Greeks, it has been only in the past decade that FAS has become a subject for research. U.S. Government and other researchers' estimates of the incidence of alcohol-caused defects range from one in 500 births to one in 10,000. The abnormalities include decreased weight, height and head size, malformations of the head and face, and mental retardation. Drinking during pregnancy has also been associated with a greater risk of miscarriage. One clue to the cause of these effects comes from National Institutes of Health Researcher Anil Mukherjee, who in 1982 showed that in monkeys the equivalent of three to five drinks consumed rapidly temporarily cuts off all circulation to the fetus, suggesting that brain damage may result from oxygen deprivation. A number of human studies have been carried out in an attempt to find out the level of alcohol consumption necessary to put the fetus in jeopardy. A two-year study at Boston University, begun in 1977, divided pregnant women into groups ranging from those who abstained from alcohol to heavy drinkers. It found that the occurrence of FAS was markedly more common among the heavy drinkers, defined as women consuming at least five drinks on one occasion and 45 drinks a month. But, says Psychiatrist Rosett, who organized the study, there was no difference in the incidence of birth defects between moderate drinkers and those who did not drink at all.

Even so, many physicians prefer to err on the side of caution. "No one knows the risk factors," says Dr. Jokichi Takamine, chairman of the American Medical Association's task force on alcoholism. He believes that pregnant women should abstain completely. Atlanta Obstetrician Donald Block, for one, is delighted with the idea of the warning signs. He says, "Now when I tell pregnant women not to drink, they are prepared."