Objective To explore the impact of perceived social support of high-risk primiparas and their spouses on theirdyadic role adaptation using the Actor-Partner Interdependence Model (APIM). Methods A convenience sample of 210 pairs of high-risk primiparas and their spouses were recruited for a cross-sectional survey. The Perceived Social Support Scale and the Family Adaptation Scale were used to collect data. The path relationships of perceived social support of both partners on dyadic role adaptation were analyzed using the APIM. Results The role adaptation scores were (78.10±9.09) for high-risk primiparas and (78.36±12.49) for their spouses. High-risk primiparas' role adaptation and perceived social support scores were positively correlated with their spouses′ respective scores. In the actor effects, the perceived social support of both high-risk primiparas and their spouses positively predicted their own and their partners′ role adaptation (all P<0.05). In the partner effects, the perceived social support of both high-risk primiparas and their spouses positively predicted their partners′ role adaptation (all P<0.05). Conclusion The role adaptation of high-risk primiparas and their spouses is influenced by their own and their partners′ perceived social support. Healthcare professionals should focus on improving the overall integrity of the couple as a support system and a co-coping entity, thereby enhancing family support and promoting better role adaptation for high-risk primiparas and their spouses.